Terminology for DCIS influences patient choices

(HealthDay News) -- The terminology used to describe ductal carcinoma in situ (DCIS) impacts treatment choices, according to a research letter published online Aug. 26 in JAMA Internal Medicine.

Zehra B. Omer, from Massachusetts General Hospital-Institute for Technology Assessment in Boston, and colleagues surveyed 394 healthy women without a history of breast cancer to examine the impact of terminology used to describe DCIS on treatment decisions. Women were presented with three scenarios describing DCIS as noninvasive breast cancer, breast lesion, or abnormal cells, and then choose among three treatment options (surgery, medication, or active surveillance).

The researchers found that among the three scenarios there were significant differences in the distribution of treatment choices. Nonsurgical options were more frequently chosen over surgery. Fifty-three percent of women preferred nonsurgical options when DCIS was described as noninvasive cancer, compared with 66 percent with a description of breast lesion and 69 percent for abnormal cells. Depending on the terminology used, significantly more women changed their preference from a surgical to nonsurgical option. For all three terms, high numeracy was the single independent predictor of surgical treatment choice.

"We conclude that the terminology used to describe DCIS has a significant and important impact on patients' perceptions of treatment alternatives," the authors write. "Health care providers who use 'cancer' to describe DCIS must be particularly assiduous in ensuring that patients understand the important distinctions between DCIS and invasive cancer."